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General NPI Number Information
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NPI Number | 1275525131
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Entity Type | Organization
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Legal Business Name | JEFFERSON TOWNSHIP
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Dates
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Enumeration Date | 08/17/2005
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 6767 HAVENS CORNERS RD
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City | BLACKLICK
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State | OH
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Zip | 43004-8317
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Country | US
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Telephone | 614-861-3757
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 392907
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City | PITTSBURGH
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State | PA
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Zip | 15251-9900
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Country | US
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Telephone | 800-962-1484
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Fax |
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Authorized Official
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Title or Position | CHIEF
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Name | BRADFORD LYNN SHULL
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Credential |
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Telephone | 614-861-3757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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